Protected Didactic Resident Teaching
Every Tuesday morning is devoted to didactic resident teaching from 9:30am to 11:30am. During this time, extra faculty are assigned hospital duty, allowing the residents to attend these educational sessions conducted by our specialist and sub-specialist faculty as well as invited faculty with specific expertise. The core topics covered each month include: MFM, Gyn-Onc, FPMRS, REI, benign gynecology, office practice, journal club, surgical skills, wellness, and research.
Our benign gyn faculty lead bedside and small group teaching to surgical service every Monday morning at 7:30.
Our Gyn-Onc faculty lead bedside and small group teaching every Friday morning at 7 AM.
Our core faculty lead small group teachings on the first and second Thursday of every month at 7:30 AM.
Senior residents lead small group teachings on Tuesdays mornings before Grand Rounds, except during interview season.
Our benign surgical faculty lead FLS (Fundamental of Laparoscopic Skills) sessions each Tuesday from 11:30-12:30 for the Gyn/Gyn-Onc teams.
Our Perinatologists make daily rounds on the Antepartum Service with the residents, and the generalist faculty make daily postpartum rounds. Our Gyn-Oncologists also round daily on their service.
Other monthly educational meetings include a multidisciplinary prenatal diagnostic conference, gyn-onc tumor board, journal club, and REI conference, as well as weekly pre-op conferences.
Our program provides an active academic teaching curriculum. Staff and residents meet for Grand Rounds every Tuesday morning at 8 a.m. These educational activities include:
- Bimonthly multidisciplinary perinatal teaching conference
- Monthly review of gynecologic morbidity/mortality
- Monthly review of obstetrical morbidity/mortality
- Conferences conducted by visiting professors
Family Planning and Contraception
Our training program provides comprehensive training in the provision of abortions as a core part of our planned curriculum. As part of our curriculum residents gain experience in managing complications of abortions and training in all forms of contraception, including reversible methods and sterilization. The following are key components of this curriculum:
- UCSF Women’s Option Clinic: PGY 2-4 on ambulatory services spend 3 half-days every week with UCSF Family Planning faculty learning to provide first and second trimester surgical and medical abortion. This includes counseling, pre-operative assessment, procedural technique, post-operative care, contraception, and management of complications. UCSF faculty help coordinate the national Kenneth J. Ryan Residency Training Program in Abortion and Family Planning programs across the United States.
- Residents on Gyn team learn advanced surgical abortion techniques with our core eight faculty who operate half day each week.
- Comprehensive contraceptive counseling and provision is addressed in resident continuity clinics and post-partum. This includes all forms of reversible contraction such as COC, patch, ring, minipill, depoprovera, implants and IUDs. Residents receive training and instruction on all LARCs.
- Residents learn permanent sterilization techniques in the clinic (e.g. essure), L&D (PPTL), and gyn (TL).
Transgender Health Curriculum
At Kaiser San Francisco, we are uniquely situated to care for a large population of Transgender patients from both San Francisco and the surrounding Bay Area. For many years, these patients have chosen Kaiser Health Plan and the San Francisco Medical Center because of our expertise and reputation in this area. We are the national referral site for gender-affirming surgery, which is a covered benefit of the Kaiser Health Plan.
Our collaborative practice includes local experts from the departments of Internal Medicine, Psychiatry, and Plastic Surgery. Our residents take part in caring for these patients, including: counseling, primary care, hormone management, and surgery (assisting with chest surgery and performing hysterectomies as well as participating in genital gender-affirming surgeries). They rotate in our Adult Gender Pathways clinic as well as in multi-disciplinary clinics with Plastic Surgery and Gynecology for patients in the perioperative period.
Residents have the option to further deepen their learning by spending an elective rotation with our transgender health team both in and out of the OR.
Our didactic curriculum includes up to date evidence-based lectures on transgender health and providing culturally competent care. We collaborate with our colleagues in Oakland to develop patient care tools, on research projects, as well as communicate regarding developing best practices. Erica Weiss, our Associate Program Director, is the regional OB/GYN Lead for Transgender health and is an active member of WPATH (World Professional Association for Transgender Health) and lectures nationally and internationally on gynecologic care for transgender patients, fertility and family building options and on gender-affirming surgery. She has collaborated with transgender specialists from both SF and Oakland, to present our cutting-edge program to a multi-disciplinary international audience. Many of our applicants choose to come to our program because of the unique opportunities to care for vulnerable populations.
Intern Orientation. This weeklong experience includes: full day procedural boot camp (NSVD; FSE/IUPC/FB; Suture Skills; Lac repairs; c/s; implants; IUDs; MVA); half day non-procedural boot camp (Hand-offs; MEOWS; Patient Safety; Delivery bad news, Team Stepps), as well as evening social events.
Advanced Life Support in Obstetrics (ALSO) Course: we send PGY1’s to this intensive evidence-based, interprofessional, and multidisciplinary training program.
Communication Skills workshop: we send PGY1’s to this day-long interactive communication and problem solving workshop.
Communication in teaching: we sent PGY2’s to this day-long workshop designed to prepare second year residents for their role as clinical teachers.
CREOG Resident Workshop: we send all PGY3s to this 2 day national course to gain and refine the knowledge and skills necessary to serve as leaders and exemplary teachers for junior residents and medical students for whom they are responsible.
UCSF Antepartum and Intrapartum Management Course and UCSF ObGyn Update: what does the evidence tell us?: available residents on ambulatory services are able to attend these courses.
Business of medicine course and Chief Resident Leadership Course: available residents may attend these two courses sponsored by Kaiser Regional GME.
Our surgical curriculum includes annual cadaver labs and robot simulation exercises at Intuitive.
Residents participate in the following clinics with close oversight from Faculty generalists and sub-specialists:
|Resident Continuity Clinic||Endocrinology/Infertility Clinic|
|Procedure Clinics: HSG, SIS, hysteroscopy, essure, myosure||Urogynecology Clinic|
|Prenatal Diagnostic Clinics: ultrasound, genetics, CVS, amnio, reductions||High Risk OB Clinic|
|UCSF Women’s Option clinic- includes first and second trimester abortion||Diabetes in Pregnancy Clinic|
|Gynecologic-Oncology Clinic||Adolescent Gynecology & Teen Clinic|
|Chronic Pelvic Pain||Multidisciplinary Kaiser Breast Clinic|
|Resident Colposcopy Clinic||Multidisciplinary Transgender Clinic|
|Women’s Hereditary Cancer Risk Clinic||Vulvo-Vaginal Disorders Clinic|
|UCSF/Mt Zion Gyn Clinic for Breast Cancer Survivors||Young Mothers Clinic|
|Intern one-on-one Continuity Clinic||Lactation Consultant Clinic|
Organized Teaching Activities
|OB M&M Grand Rounds||Monthly|
|Perinatal Grand Rounds||Bimonthly|
|Prenatal Diagnostic Conference||Monthly|
|Resident OB/Gyn Journal Club||Monthly|
|Gyn M&M Conference||Monthly|
|Gyn-Onc Tumor Board||Monthly|
|High Risk Ob Rounds||5 days/week|
|Protected Didactics (2 hr)||Weekly|
|Departmental Journal Club||Quarterly|
|Hereditary Cancer Risk Conference||Monthly|
|Resident Research Meeting||Monthly|
|Gyn Video Conference||Monthly|
|Benign Gyn and Gyn-Onc Small group teaching||3x/week|
|Ambulatory Small group teaching||2x/week|
Surgical Skills Curriculum and Simulation
We have a robust and comprehensive surgical skills curriculum. Once a month during protected teaching time our residents participate in hands-on simulations, both low and high fidelity. We have multiple hysterectomy simulations throughout the year, during which residents rotate at one of three stations: vaginal, abdominal and laparoscopic. Our models are state of the art and provide an excellent opportunity to practice all steps of each procedure. We also have dedicated sessions on suture skills, myomectomy/cystectomy, hysteroscopy, fourth degree repairs, office procedures (such as LEEP, biopsies and colposcopy,) second trimester terminations and sub-urethral slings.
Residents participate in laparoscopic cadaver labs. Faculty are extremely committed to activities such as this and cover resident services so that each and every resident may attend all sessions.
Interns begin the academic year with a comprehensive boot camp featuring hands-on practice of laceration repairs, vaginal and cesarean deliveries, suture skills, labor and delivery procedures, IUD’s and manual uterine aspiration.
We have a dedicated simulation room for laparoscopy. Twice monthly groups of 2-3 residents at a time are excused from clinical services to participate in laparoscopy simulation with one of our gyn surgical faculty. We have laparoscopic trainers that are used during this time. These trainers are available for use at all times to practice tasks and suturing both.
Each PGY 1 and 2 participate in the Fundamentals of Laparoscopic Surgery program, becoming adept as task trainer activities that directly correlate to improved dexterity in the operating room.
Our chiefs serve as teaching assistants in the simulation setting, helping them to learn to become better teachers in the operating room. Our faculty is dedicated to helping senior residents be primary surgeons on surgical cases and support this transition once they feel they are ready.
We also have a comprehensive longitudinal curriculum for robotic training in gynecology that includes simulation, dry lab exercises, bed side assist and console surgery.
These activities support our direct teaching in the operating room and we assess learners both in and out of the OR. Residents receive surgical skill evaluations at the time and these are also included in their semi-annual reviews.
myTIP: Milestone and Procedural Evaluation and Feedback for Obstetrics and Gynecology
The practice of high quality Obstetrics and Gynecology involves: the ability to perform a wide variety of surgical and technical procedures with skill; as well as ability to master the 6 core competencies (patient care; medical knowledge; systems based practice; interpersonal and communication skills; professionalism; practice-based learning and improvement). To provide a mechanism for receiving immediate faculty feedback as well as to assist in assessing progress and documenting competency, specific key procedures have been identified for focused observations to be completed in which the resident is the primary surgeon. With the use of the myTIP mobile application, we can easily track residents’ progress throughout the year as we have constructed these assessments to integrate in to our milestones evaluations.
Our residents actively participate in a robust interdisciplinary clinical quality improvement and patient safety program. Several members of our clinical faculty are certified simulation educators and patient safety leaders. These safety leaders run a formal clinical quality improvement and patient safety curriculum which includes a didactic curriculum, small group simulated patient safety exercises and mentorship for each resident’s yearly clinical quality improvement and/or patient safety project. Residents participate in the safety initiatives for our department, labor and delivery unit and regional Kaiser Permanente and chief residents are participating members of our Perinatal Patient Safety Program. Residents are also trained to care for patients in an environment that maximizes effective team communication using the Team Stepps model. This includes opportunities to work as a member of effective inter-professional teams to provide the highest quality delivery of care.
Under the umbrella of our larger patient safety and clinical quality improvement curriculum is our esteemed Critical Event Team Training (CETT) program. These multidisciplinary obstetrics emergency simulation training events are held every two to three months and led, assessed and tracked by Dr. Stephanie Terry, certified health simulation educator. Two in-situ CETT’s are run each session and allow for multidisciplinary team practice of management of obstetric emergencies and effective team communication. Participants include OB/GYN Residents and faculty, Anesthesia team, Neonatology team, Maternal Child Health RNs, OB technicians, blood bank and other ancillary support staff.
We have a longitudinal curriculum for ultrasound training. It includes didactics, simulation, clinic experience (with radiologists, general ob/gyn specialists, and Maternal-Fetal-Medicine sub-specialists), and direct observation with Focused Assessment of Competency. Residents are trained to provide the full complement of obstetric and gynecologic ultrasonography including but not limited to trans-vaginal and abdominal obstetric ultrasounds for assessment of fetal growth, wellbeing and anatomy, trans-vaginal gynecologic pelvic ultrasounds and saline infusion sonography.
Departmental Journal Club